Concession of sickness benefit to social security beneficiaries due to mental disorders

Abstract

Assess the odds of having an initial claim for statutory sickness benefit awarded (ascribed to mental disorder as the main registered diagnosis), in relation to institutional, clinical, sociodemographic and welfare factors in Juiz de Fora-MG, Brazil. Two models of logistic regression, taking into account the categories of the medical examiners, were built with the aim of characterizing the relative weight of several variables affecting the medical conclusion. The factors more strongly related to an award of benefit were claimants assessed by a physician without a specialization in psychiatry; with a diagnosis of psychosis; up to 29 years of age; with other non-psychiatric (musculoskeletal and cardiovascular) co-morbidities; registered with the national insurance system as employed; and male. In both models, examiners with a specialization in psychiatry were associated with a lower likelihood of award of benefit. This suggests that examinations undertaken by doctors having a specialty related to the diagnosis supporting the sickness benefit claim are stricter than those undertaken by non-specialists. The results suggest that benefit award odds were associated with the specialty of the examiner, medical diagnosis, age, gender and claimant category.